Hospital CIOs: If I could do one thing over ...

With so many decisions for a hospital CIO to make--from choosing an electronic medical record system to deciding whether or not to go forward with the transition to the ICD-10 coding system--is it any wonder that a few of those decisions might not turn out exactly as planned? That there would be initiatives that, with the luxury of hindsight, would never have seen the light of day?

Of course, there are some who might not like to admit it. But these four fearless CIOs understand that the road to improvement is paved not with perfection but, sometimes, with "lessons learned." 

FierceHealthIT asked four CIOs about those lessons learned and which decisions, looking back, they wish they could "do over."

Here's what they had to say:

Stephen StewartStephen Stewart (pictured right), CIO at Henry County Health Center in Mount Pleasant, Iowa, said that while at a previous job, he gave the green light to a $2.2 million mainframe upgrade just as servers were becoming the wave of the future.

"I just completely missed it," Stewart said. "I no more than got it installed and two years later, everything we were doing was servers and we couldn't figure out how to get mainframe out fast enough.

"What I was most disappointed in," Stewart added, "was that I was too myopic in my view and couldn't see the bigger picture."

David HollandAn expensive system implementation at a previous stop also haunts David Holland (pictured left), currently CIO at Carbondale, Ill.-based Southern Illinois Healthcare. Holland and his team implemented a new IT system for HR that, after only a few months, was abandoned.

"The VP of HR refused to sponsor the system, [and] said it was an IT system and that I should sponsor it," Holland told FierceHealthIT. "That was the last system I implemented without a business system sponsor. I should have pulled the plug on the project when [it received] little to no support."


John HalamkaJohn Halamka (pictured right), CIO at Beth Israel Deaconess Medical Center in Boston, said his do-over would involve getting more feedback as well, and that he would have built in more stakeholder governance earlier.

Although BIDMC created several governance committees--including an overall IT governance committee--in 2010, Halamka told FierceHealthIT that it should have happened sooner.

"In a world of increasing demand and limited IT resources, governance is key," he said. "IT projects are a function of scope, time and resources. Governance committees can control the scope [taking work off the plate, if needed], time [changing deadlines] and resources" to support the addition of staff or budget.

"Today's consumer IT marketplace, with product lifecycles of six months, creates unrealistic expectations for IT departments," Halamka added. "Building strong governance earlier would have given me more proactive opportunities to set expectations before the advent of the consumer IT revolution. Today, I'm still reacting to daily requests for ‘flying cars' and ‘transporters.'"

Roger Neal

Similarly, Roger Neal (pictured left), CIO at Duncan (Okla.) Regional Hospital, said he regrets not involving the medical staff enough in the building of the facility's computerized physician order entry system last year.

"Yes, we had a medical informatics committee in place. Yes, they met monthly and approved things. But I think for our rural facility, the project would have been a lot better initially if we had included more of our physicians and done more to communicate all the changes that were going to be  happening," Neal said.

"Having more of our physicians involved at the start, even in a minor role, would have given us a bigger bang when the system went live."

So what do all these CIOs have in common? The answer is not just that they have moments in their careers that they wish they could do over. It's that they took that information and used it to their advantage on the next project.

Stewart said mistakes, while unwanted, help to frame future decision-making efforts.

"I always think back from mistakes made over the years ... and clandestinely ask myself ‘have I done the right thing?'" he said. "I don't think you can let it slow you down, too much, but you also have to get to a point in time where you develop patience. Things don't have to be done yesterday, but you can't get into analysis paralysis and think about things forever.

"You have to get the best information you can get, evaluate it, synthesize it, and move on."

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